The Oxford Covid-19 vaccine could do more for the world than other vaccines

The average reported efficacy of 70% was significantly lower than the 94.5% to 95% reported by the other two leading candidates, Moderna and Pfizer.

“[T]The Pfizer vaccine is committed to its initial doses, which go to the European Union and the United States. Moderna’s supplies will be tied to the US at least in the first half of 2021, so in light of that, the Oxford / AstraZeneca vaccine is really good news for the rest of the world, ”Andrea Taylor, Assistant Program Director at Duke Global Health Innovation, told CNN.

AstraZeneca promised to supply hundreds of millions of doses to low- and middle-income countries and to provide the vaccine on a non-profit basis for those countries in perpetuity. The vaccine developed at the University of Oxford in England is much cheaper than the other vaccine, and most importantly, it will be much easier to transport and distribute in developing countries than its competitors because it does not need to be stored in freezing temperatures.

“I think it’s the only vaccine that can be used in those places at the moment,” Azra Ghani, head of infectious disease epidemiology at Imperial College London, told CNN.

Technology

The Oxford / AstraZeneca vaccine can be kept at a refrigerator temperature of 2 to 8 degrees Celsius (36 to 46 degrees Fahrenheit) for at least six months. A modern vaccine They should be stored at -20 ° C (-4 ° F) – or refrigerator temperatures for up to 30 days – and Pfizer / BioNTech Vaccine It should be stored at -75 ° C (-103 ° F), and used within five days once cooled at higher temperatures.

“Pfizer and Moderna require freezer storage, and this is not present in many places,” said Ghani.

Cold Chain Cold is the standard storage used worldwide to deliver vaccines from central sites to local health clinics. Ghani added that so far, the AstraZeneca vaccine “is the only one that can definitely be delivered to these systems.”

Vaccines depend on various technologies. AstraZeneca’s offer – like Russia’s Johnson & Johnson and Sputnik V vaccine – uses adenoviruses to transfer genetic parts of the coronavirus to the body.

The Moderna and Pfizer vaccines use pieces of a genetic material called messenger RNA (mRNA) to stimulate the body to make artificial pieces of the coronavirus and stimulate the immune response. “This is a relatively new technology and little is known about the stability of mRNA over time,” Benny Ward, Chair of the Education and Standards Committee at the UK School of Pharmaceutical Medicine, told CNN.

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She said it in the name of Moderna and Pfizer Building information and manufacturing capacity, they may be able to find ways to store at higher temperatures, but the Oxford vaccine “has the potential to be able to ship more easily around the world” using existing supply chains.

However, it will only be of value if levels of vaccine efficacy are maintained during deployment in developing countries.

This week, AstraZeneca said trials showed one dosing regimen produced 62% potency while the other achieved 90%, an average of 70%. This is a good result, it can be compared to the flu vaccine, but it is not as high as Pfizer 95% And the Modern 94.5%. The figure of 90% is based on a sample of 2,741 participants, which is a relatively small number.

Moncef Salawi, senior advisor for the US government’s Warp Speed ​​Operation, said this week that there are “a number of variables that we need to understand” about the differences in dose and age in the Oxford / AstraZeneca results, and then the ongoing US experience may need to be adjusted.

On Thursday, a spokesperson for AstraZeneca told CNN that they are currently in discussions with the FDA about including a half-strength dosing regimen in their US trials, which currently have about 10,000 participants.

“The simplicity of dispensing the AstraZeneca vaccine could compensate for the low potential effectiveness,” said Ever Ali, Associate Professor of International Business at Warwick Business School.

“The actual effectiveness of more fragile mRNA vaccines in transport and storage may be lower in real-world conditions where it may be difficult to verify the correct storage of each dose,” she added.

BioNTech said last week that it was working with Pfizer to come up with a formula that would allow its vaccine to be stored at record temperatures by the second half of 2021. Moderna this month expanded its estimate of how long its vaccine could be stable in refrigerator temperatures from an estimated seven to 30 days. This, according to Moderna’s chief technical officer and quality officer, Juan Andres, “would enable simpler distribution and more flexibility to facilitate wider vaccination in the United States and other parts of the world.”

Pledge to help

AstraZeneca has pledged 300 million doses of its vaccine to COVAX, a partnership between GAVI, the Vaccine Alliance; World Health Organization; Alliance for Epidemic Preparedness Innovations (CEPI) to ensure equitable distribution to 92 developing countries. The only other known vaccine developer to pledge the same volume is Sanofi, with 200 million doses.

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A representative of the Global Alliance for Vaccines and Immunization told CNN that the Vaccine Institute of India (SII) and the Bill and Melinda Gates Foundation will also provide up to 200 million doses of AstraZeneca and / or Novavax candidate vaccines for low-income countries. Moderna and Pfizer have not pledged any dosages for COVAX.

This could mean that AstraZeneca has more manufacturing capacity than other drugs thanks to its ties to industry giants such as Strategic Impact Inquiry Through CEPI.

“[AstraZeneca has] You’ve been working with the manufacturing experts in this alliance to help get a variety of different manufacturing sites, and of course it’s not just the vaccine itself, it’s also the glass vials it goes into, the stoppers that go over the bottles, and the syringes, Ward said.

A volunteer receives an injection at Chris Hani Baragwanath Hospital in the suburbs of Johannesburg, on June 24th as part of South Africa's first participation in the Oxford / AstraZeneca vaccine trial.
AstraZeneca It says it expects to be able to produce up to 3 billion doses of the vaccine in 2021 on a rolling basis. Pfizer / BioNTech says it can manufacture up to 50 million doses in 2020 and 1.3 billion in 2021, while modern It says it expects to be able to deliver approximately 500 million doses per year and possibly as many as 1 billion doses per year starting in 2021.
Yet calls for transparency from groups like Medicines without limits And the Global justice nowAstraZeneca and Oxford confirmed that the partnership will provide the vaccine on a non-profit basis until at least July 2021 around the world, and in perpetuity for low- and middle-income countries.
Oxford vaccine is almost cheaper than other vaccines $ 3 to $ 4 For each dose in reverse About $ 20 Pfizer Vaccine and $ 32-37 Moderna vaccine.

An Oxford University spokesman told CNN: “Our vaccine can be rapidly deployed in the current health conditions, which will help stop the further spread of this disease as we learn more and more about how to prevent and treat it.” He added that a group of vaccines would be needed, and some of them could be more effective for different ages and populations.

He said, “The key with any vaccine is that it can affect public health, including how quickly it can be distributed. We can be quickly and easily distributed around the world, using existing logistics services, and easily stored in the refrigerator.”

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Global effects

COVAX will be critical in getting the vaccine to low and middle income countries, Modeling by Duke University Offers. The initiative aims to provide two billion doses by the end of 2021 to protect vulnerable groups around the world, and ultimately enough doses to cover 20% of the population of those countries.

However, Ghani warned that the 20% “was not close to the ideal – about 70% – that we would like to see so that we can achieve herd immunity, so some countries will still fall short.”

She said it is imperative for everyone that the world’s population be vaccinated, to enable them to travel and move across borders. Can spread the vaccine in the world It takes until 2023, According to current models – not to mention the potential need for Booster shots.
Here's a look at how different coronavirus vaccines work
“Accessing safe and effective COVID-19 vaccines for the most vulnerable everywhere in the world is the only way to control the acute phase of this epidemic,” said Dr. Seth Berkeley, CEO of Gavi, and also welcomed news of the Oxford vaccine in A statement this week.

Duke’s modeling shows that while wealthier countries may have purchased billions of doses up front to increase their chances of covering their populations, the developing world will depend entirely on COVAX.

Bill Gates said that the solution “does not expose the shame of the rich countries that do the natural thing of wanting to protect their people,” rather, it was to greatly increase their manufacturing capacity.

Stephen Evans, professor of pharmacological epidemiology at the London School of Hygiene and Tropical Medicine, cautioned that monitoring efficacy and safety issues will be an ongoing challenge in the developing world.

He told CNN: “There may be some negative effects that may only appear in those low- and middle-income countries; they have different diets, different levels of nutrition in general, and different characteristics.”

While the Oxford vaccine may have special promise at this point to help low-income countries, there are still many caveats about the data that must be resolved before it is even released.

Ultimately, it will be necessary to get the largest number of vaccinations possible, to ensure a faster recovery and to limit further damage to the world.

CNN’s Harry Clark Ezidio, Jane Christensen, Maggie Fox, and Cara Fox contributed to the reports.

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